<form id="formEditLayanan">
		<td></td>
		<td>
			<input type="text" class="form-control input-sm" disabled="" value="<?= $layanan_klaim['layanan'] ?>">
			<input type="hidden" id="id_layanan_klaim" name="id_layanan_klaim" value="<?= $layanan_klaim['id_klaim_layanan'] ?>">
		</td>
		<td>
			<input type="text" class="form-control input-sm" disabled="" id="eltarif_perda" name="eltarif_perda" value="<?= $layanan_klaim['tarif_perda'] ?>">
		</td>
		<td align="center">
			<input type="text" class="form-control input-sm" id="eljumlah" name="eljumlah" value="<?= $layanan_klaim['frekuensi_diminta'] ?>">
		</td>
		<td>
			<input type="text" class="form-control input-sm" id="eltarif_diminta" name="eltarif_diminta" value="<?= $layanan_klaim['tarif_diminta'] ?>">
		</td>
		<td>
			<input type="text" class="form-control input-sm elsubtotal" id="elsubtotal" name="elsubtotal" disabled="" value="<?= ($layanan_klaim['tarif_diminta']*$layanan_klaim['frekuensi_diminta']) ?>">
		</td>
		<td>
			<button id="updatel" type="button" class="btn btn-sm btn-success btn-flat"><i class="fa fa-floppy-o"></i> Simpan</button>
			<a class="btn btn-sm btn-danger btn-flat" href="#pilih_layanan" onClick="return get_layanan_klaim()"><i class="fa fa-power-off"></i></a>
		</td>
</form>